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Related Concept Videos

Endocarditis II: Clinical features and Diagnostic Tests01:25

Endocarditis II: Clinical features and Diagnostic Tests

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Endocarditis can present various clinical features depending on the causative organism and the patient's underlying health conditions. Initially, the clinical features of infective endocarditis develop gradually, presenting with nonspecific symptoms that can be easily mistaken for other illnesses.General SymptomsEarly symptoms of infective endocarditis are fever, chills, weakness, malaise, fatigue, and weight loss. These symptoms reflect the systemic nature of the infection and the body's...
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Imaging Studies for Cardiovascular System III: X-Ray01:20

Imaging Studies for Cardiovascular System III: X-Ray

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The most common cardiovascular diagnostic test is an X-ray. It produces images of the heart, blood vessels, and adjacent structures.
Definition and Purpose
An X-ray, or radiograph, is a non-invasive method that uses ionizing radiation to take images of internal structures. It is mainly used in cardiac imaging to examine the heart, lungs, and major blood vessels, aiming to identify abnormalities in the heart's size, shape, and position, such as heart failure, congenital defects, and vascular...
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Imaging Studies for Cardiovascular System V: CT01:28

Imaging Studies for Cardiovascular System V: CT

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Cardiac computed tomography (CT) scanning is an advanced cardiac imaging technique that utilizes CT technology, with or without intravenous (IV) contrast, to produce accurate cross-sectional virtual slices of specific areas of the heart, coronary circulation, and major blood vessels such as the aorta, pulmonary veins, and arteries. The computer processes these slices to generate three-dimensional images. Multidetector CT (MDCT) is a rapid form of CT scanning that captures multiple slices...
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Pericarditis II: Clinical features and Diagnostic Tests01:19

Pericarditis II: Clinical features and Diagnostic Tests

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Pericarditis is distinguished by inflammation of the pericardium, the fibrous sac that encases the heart. It can be acute, lasting less than six weeks, or chronic, persisting for over three months. Understanding its clinical manifestations and diagnostic findings is crucial for timely and effective management.Clinical ManifestationsWhile pericarditis can be asymptomatic, it usually presents with characteristic symptoms such as:Chest Pain: The most characteristic symptom of pericarditis is chest...
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Myocarditis II: Clinical features and Diagnostic Tests01:27

Myocarditis II: Clinical features and Diagnostic Tests

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Myocarditis is an inflammation of the heart muscle. The symptoms vary widely, encompassing asymptomatic presentations to severe, acute manifestations.Clinical PresentationAsymptomatic cases: In some instances, myocarditis may be asymptomatic, with the infection resolving without intervention. These cases often go undetected unless discovered incidentally through diagnostic imaging or tests conducted for other reasons.General Early Symptoms: Early symptoms of myocarditis are non-specific and can...
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Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies01:22

Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies

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The key clinical manifestations of Rheumatic heart disease (RHD) include several distinct cardiac symptoms.Carditis, a hallmark of acute rheumatic fever, involves inflammation of the heart's endocardium, myocardium, and pericardium. Chronic RHD often results from recurrent episodes of carditis. Its symptoms include the following:Murmurs are caused by valvular damage, especially to the mitral and aortic valves. Mitral stenosis or regurgitation is common, with characteristic heart murmurs...
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Indirect-Oscillation Sign Suggesting Infective Endocarditis on the Routine Chest CT.

Min Ji Son1, Seung Min Yoo1, Hwa Yeon Lee2

  • 1Department of Radiology, CHA University Bundang Medical Center, Bundang 13496, Republic of Korea.

Journal of Cardiovascular Development and Disease
|October 25, 2024
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Summary

Routine chest CT can suggest infective endocarditis (IE) using an indirect-oscillation sign. This finding, though uncommon, indicates potential movable vegetation when present on standard CT scans.

Keywords:
chest CTinfective endocarditissplenic or renal infarction

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Area of Science:

  • Cardiology
  • Radiology
  • Infectious Diseases

Background:

  • Routine chest CT is not standard for infective endocarditis (IE) diagnosis.
  • CT may be the first imaging test for IE patients with vague symptoms in the ED.
  • Standard CT lacks cine imaging, preventing direct assessment of valve motion.

Purpose of the Study:

  • To investigate if the "indirect-oscillation sign" on routine chest CT can suggest IE.
  • To evaluate a combination of valve thickening, abnormal orientation, and blind ends as an indirect sign of vegetation.

Main Methods:

  • Retrospective analysis of routine chest CT scans from 27 IE patients and 35 controls.
  • CT scans were performed 60-80 seconds post-contrast administration.
  • Two cardiothoracic radiologists assessed for the indirect-oscillation sign.

Main Results:

  • The indirect-oscillation sign showed 29.6% sensitivity and 100% specificity for IE.
  • Positive and negative predictive values were 100% and 64.8%, respectively.
  • The sign was identified in 8 of 27 IE patients.

Conclusions:

  • The indirect-oscillation sign on routine chest CT is a rare but suggestive finding for infective endocarditis.
  • This sign may indirectly indicate movable vegetation on aortic or mitral valves.